Purpose: To describe current practice of pediatric sternal precautions (PSPs) and prone positioning restrictions (PPRs) in infants after median sternotomy. Methods: A Web-based survey with 21 questions was developed on the basis of a review of current literature and expert consultation. Snowball sampling resulted in 68 participants well represented by profession throughout the United States. Results: Approximately 80% of participants reported having institutional protocols for PSPs. Most common reported PSPs were no lifting at the axillae and no pulling of arms to achieve sitting. PSPs also included PPRs. The opinions of participants supported no PPRs or modified PPRs compared with strict PPRs. Conclusions: Types of PPRs varied across participants, with the majority of participants in favor of modified PPRs while PSPs were less varied. Research is needed to examine the effects of PSPs and PPRs in infants post–median sternotomy.

Objective: The purposes of this study were to identify and describe the attributes of excellence and innovation in professional pediatric physical therapy education and develop a conceptual framework identifying dimensions of excellence. Methods: A multimethod case study design based on a grounded theory framework was used. Data collection included review of artifacts and field interviews (individual and focus group). A constant-comparative method for within case and across case was used for data analysis to verify and revise coding schemes, identify categories and subcategories, revise emerging themes, and develop a conceptual framework. Results: Based on results of a predetermined grading rubric, 6 of 17 self-nominated academic sites were selected representing diverse institution types (public/private, Carnegie classification, size) and geographic locations. Pedagogical approaches and method of content delivery varied among programs; all used the essential core competencies. The core pediatric faculty member(s) were Board Certified Clinical Specialists. A conceptual framework was developed based on 4 key dimensions: Culture of Excellence, Exemplary Pediatric Faculty, Pedagogy, and Child and Family as Teacher (CFT), and 16 related elements. Conclusions: CFT is a unique and nonnegotiable dimension of excellence in pediatric physical therapy education, highlighting the partnership between the learner, child, family, and pediatric faculty member. CFT intersects with the other dimensions and integrates their elements (ie, faculty characteristics, contributions from the child and family, use of instructional strategies) to effectively prepare future pediatric physical therapists. Based on the pervasiveness of this dimension in teaching and learning across all programs, this may be the signature pedagogy of pediatric physical therapy education. Impact: Results of this study are important to professional physical therapist education administrators, pediatric academic faculty, and clinical educators because they represent an understanding of the attributes of excellence. The model can serve as a guide for best practice in pediatric physical therapy education.

The purpose of this Perspective is to present an application of script-based reasoning to physical therapist education and practice. Illness script–based reasoning has been described as a cognitive strategy for medical practitioners to diagnose and manage health conditions. Analogous to this medical model of patient management, “movement scripts” can be used by physical therapists in clinical reasoning. Movement scripts use features of the human movement system to recognize, categorize, and substantiate clinical problems and can be used to facilitate the development of master adaptive learners across the spectrum of physical therapist education and practice. Movement scripts are also consistent with the concept of the “human body as teacher” as the signature pedagogy proposed by the National Study of Excellence and Innovation in Physical Therapy Education. Movement of the human body, as captured by the concept of the human movement system, is a vehicle for lifelong adaptive learning for the physical therapist. Script-based learning and practice are consistent with other elements of this model, including practice-based learning and the creation of adaptive expertise. As the role of the movement system as a guide to physical therapist practice continues to evolve, movement scripts can provide a structure to facilitate development of clinical reasoning skills for physical therapist practice and education.

Objective: The purpose of this study was to describe common perspectives important to achieving excellence and success in physical therapist residency education programs. Methods: Individuals with direct responsibility for creating and revising physical therapist residency program goals participated in a mixed-methods study using Q-methodology. They sorted 31 goal topics based on the level of importance for achieving excellence and success in physical therapist residency education. By-participant factor analysis identified dominant perspectives, which were interpreted based on emergent themes from the topics identified as the most important. Participants’ rationale for selecting goal topics as the most important were extracted from the post-survey. Results: Seventy-three individuals responded, representing 9 of the 11 clinical residency areas of practice. Three main perspectives emerged: resident behaviors, resident achievements, and program attributes. One shared perspective emerged across all 3 factors that emphasized the residents’ ability to become self-regulated, lifelong learners who integrate learning into practice: preparation for future learning. Conclusions: Variability in weighting the importance of program goals associated with each perspective may include a program’s organization and mission, individual beliefs and experiences related to program leadership, and resource availability. Although respondent emphasis placed importance of some items over others, the findings do not suggest that items ranked lower were unnecessary or unimportant in achieving program excellence. The relative importance of items was weighted differently based on the perspective of program leadership and the individual completing the sorting activity. Impact: The results of this study suggest that physical therapist residency programs should have at least 1 or 2 goals in each of the 3 distinct perspectives, as well as the 1 shared perspective identified in our findings. Some consistency in program goals based on the perspectives identified here may enable further research exploring excellence, value, and outcomes in physical therapist residency education.

Children and adolescents (C&As) with congenital heart defects (CHDs) have decreased functional capacity and executive functioning (EF) due to brain abnormalities and decreased cerebral perfusion. Exercise may improve EF via increased cognitive demands and cerebral blood supply. The purpose of this review was to identify evidence describing the impact of physical activity (PA) interventions on EF in C&As with CHDs. The following databases were searched from 2000 to 2024: MEDLINE, EMBASE, CINAHL, Scopus, CENTRAL, and PsycInfo. The inclusion criteria consisted of participants aged from birth to 18 years with CHD, interventions related to PA, and EF as an outcome measure. Articles were excluded if adults were included, translation to English was impossible, and full access was unavailable. Of 613 initial articles, 3 were analyzed, with only 1 meeting all inclusion criteria. The included study found significant improvements in self-reported cognitive functioning and parent-reported social functioning after 12 weeks of aerobic exercise in children aged 10–15 years with CHDs. Common themes among the reviewed articles indicated that EF remains impaired throughout the lifespan, children have unique interventional and developmental needs, and research remains limited despite theoretical benefits. Further investigation of the effect of PA on EF in C&As with CHDs is needed.

Purpose: The purpose of this pilot case series was to describe participation in high-intensity gait training (HIGT) and changes in (1) gait speed/endurance, (2) aerobic capacity, and (3) walking ability in children diagnosed with cerebral palsy (CP). Methods: Three children with CP participated in HIGT for 5 weeks in lieu of their routine physical therapy. Outcome measures were collected at baseline and post-intervention. Results: Post-intervention, all had at or above the minimal clinically important difference for 10-m walk test speed and 6-minute walk test distance. Two participants performed above the minimal clinically important difference in 7.5-m shuttle run test level and Gross Motor Function Measure—88 Dimension E score. Conclusion: This case series demonstrates short-term improvements in the walking outcome measures with participation in HIGT. Further research is needed with a larger and more diverse randomized controlled trial to determine parameters and long-term effects of HIGT in this population.